The Patient with Pituitary Disease

Abstract

A 41-year-old woman with the diagnosis of a suprasellar lesion was admitted for transsphenoidal hypophysectomy. The patient reported a 1–2 year history of headaches, with decreasing vision in the left eye. She also noted postmenopausal bleeding for 3 years. She denied other neurologic or physical problems at the time of admission.

She had previously had a pilonidal cyst excision under general anesthesia without problems. Medical history was negative for hypertension, diabetes mellitus, cardiac symptoms, respiratory disease, or allergies, and the patient was not taking any medications. She smoked one pack of cigarettes a day but denied alcohol or drug use.

Physical examination revealed an obese woman (245 lb), who was alert, oriented, and cooperative. Vital signs were within normal limits. Head and neck examination revealed 4 missing upper teeth, but no other abnormalities were found. Chest examination was negative with lungs clear, and no cardiac murmurs. On neurological examination, the patient demonstrated intact cranial nerves but had a deficit in the left lateral visual field. No abnormalities were found on motor and sensory examinations.